OBJECTIVES: Headache is a highly prevalent disorder that is often associated with a wide range of functional multi-morbidities (Errico, 2014). In primary care it is typical for each condition to be treated in isolation, and as a result multi-morbid patients place a huge burden on the health system. The aim of this project was to develop a de novo early economic model to assess the cost-utilty of using a non-invasive vagus nerve stimulation (nVNS) therapy in primary care, for patients suffering with headache and multi-morbidity. METHODS: The cost-utility analysis was conducted from the perspective of the English National Health Service, utilising EQ-5D-5L and healthcare resource data collected from nVNS primary care clinics designed to treat multi-morbid patients (n=233). Resource utilisation data were combined with unit cost data to determine the cost implications of multi-morbid patients either with, or without, the use of nVNS. The primary output of the model was an estimated incremental cost-effectiveness ratio (ICER) comparing nVNS + standard care, to standard care alone over a 12 month period. Net monetary and net health benefit were also calculated. Due to uncertainty in input parameters, extensive deterministic sensitivity analyses were conducted. RESULTS: The preliminary analysis estimated an ICER of £13,368 per quality-adjusted life year (QALY) gained when comparing nVNS + standard of care, to standard of care alone. Furthermore, a net monetary benefit of £631 and a net health benefit of 0.03 QALYs gained were calculated based upon a £20,000 per QALY threshold. Improvement in utility score with nVNS was the key driver of the analysis. CONCLUSIONS: The preliminary results of the economic evaluation of nVNS compared with standard care suggest that gammaCore is a cost-effective treatment for patients with multi-morbidity from the perspective of the NHS.